The Cancer Conversations You Need to Have: A Caregiver Guide

Geez, aren’t there enough cancer conversations already?

Yikes man. My partner has cancer. What cancer conversations could you possibly want me to have?

Yeah, I know. I apologize. But I hope to help other caregivers out just by sharing my personal experiences and advice about cancer conversations.

The cancer conversations I am talking about are discussions that need to be had with your partner. It sucks to say but cancer introduces a new type of dynamic between you and your loved one. If you’ve ever started a new job, been in a new romantic relationship, or made a new friend, you know that relationship dynamics don’t come to fruition immediately. They take some time to develop. They are a living breathing thing that constantly changes to adapt when the needs arise. Becoming a cancer caregiver is like starting that new job with some tough relationships that need to be nurtured over time.

Hopefully we all know that the best way to form healthy relationship dynamics is to communicate. Say it with me. Com-mun-icate.

Com-mun-icate? That’s your big secret?!

Hold your horses, cowboy! I’ll expand on this in a sec! Sarah received her breast cancer diagnosis after we had been together for about 4 years. It was also right around the time I asked her to be my wife. Up to that point, her and I established the healthy dynamics of our relationship. We valued open communication and emotional support for each other. Neither Sarah nor I ever looked to put the other one down.

However just like any other couple, we came into the relationship with different communication styles, conflict resolution strategies, emotional tendencies, and all the other things that made us unique individuals. Where did these differences between us come from? Well, any therapist or human development expert would tell you that the differences came from our childhoods and families. And we grew up in VASTLY different types of families.

Any stressful burden that life throws at us tests our relationships, Cancer meant that those differences that Sarah and I brought into the relationship were amplified. I came up with a formula that describes my personal struggles with this:

Our individual differences + cancer + the isolation and challenges of being a caregiver = Not a fun time

cancer math
Please don’t make me do math.

Oops sorry. That’s my inner nerd coming out. After 2.5 years of caregiving for my partner, I found that the only thing to counteract this math is to communicate effectively. Establishing communication patterns is essentially the same thing you did when you started dating your partner. This time, it’s just a little more stressful. Okay, maybe it is a lot more stressful. There are so many new things that were just introduced into your life with cancer. To ensure that you set yourself and your partner up for success, you need to initiate the cancer conversations with your partner about these key topics:

  1. Openness and vulnerability – “I’m here for you every step of the way. With cancer, it is now more important than ever for you to feel comfortable sharing your feelings with me.”

Sarah grew up in a family that simply did not have an open and comfortable approach to discussing their feelings – especially the bad ones. This was totally new to me when we started dating! I came to learn that Sarah grew up believing that it was a bad thing to talk about her feelings or verbalize a need for help. As a child, Sarah’s expression of emotion was not fully heard or validated by her parents (they were still absolutely supportive throughout her life, just not fully in this way). In my first trauma post, we learned that children will implement lessons from their childhood experiences into the rest of their lives. Thusly, Sarah learned “I have to suppress my emotions in order to feel ‘safe'”.

Cue cancer. Sarah struggled with a lot of difficult feelings and emotions, but she suppressed those bad thoughts. It was her default to stuff them down and try to handle them internally. However, cancer is too shitty to handle internally. When I noticed Sarah was struggling, I desperately tried to have those deep conversations with her about what she was feeling. I felt a sense of helplessness and disconnectedness when I was unsuccessful. My partner was no longer sharing pieces of her life that she used to share. Every healthy relationship requires vulnerability. Unfortunately when cancer introduced itself, I failed to establish the new dynamic for her to feel safe being vulnerable with me during the most difficult time in our life. Please don’t make the same mistake and have this discussion with your partner.

cancer feelings
feelings.

  1. Mutual love and respect – “I love you. We are at the hardest crossroads in our life and no matter what, I want us to always respect and validate each other.”

Now, there’s a funny thing that happens when someone tries to stuff down their feelings. If you try to plug a big leak by covering the hole with your finger, pressure builds and that water will find a different way to explode out. Sarah’s suppression of feelings didn’t mean that the stress and difficult emotions vanished out of thin air. Instead, you can bet those feelings found a different way to bubble up.

The brain subconsciously tries to protect the more fragile pieces of ourselves by not showing those fragile pieces to others. The feelings are withheld from even the most safe and loving people in that person’s life. A sad thing often happens with caregivers and their partners. The partner with cancer wants to show the rest of the world their strength and positive attitude. It’s their form of self-protection. At home, the unacknowledged feelings have no where to go. If they aren’t being processed, they can’t stay inside for ever either. The partner ends up directing the stress, cancer anxiety, difficult emotions, and the whole kitchen sink to the caregiver. I can tell you one thing – It. Is. Hard.

I wished I addressed this directly and very early on. It was impossibly challenging for me. My partner, instead of allowing me to help her process the more complicated thoughts, used me as an outlet to let out that frustration and stress. When this happened, I just felt really low. It brought up so much anxiety, depression, and really low self-esteem. Not to mention that in these situations, there isn’t much room for the caregiver’s challenging emotions when this all arises. Of course I understood that these actions were not ones that Sarah consciously chose. Nonetheless, I found myself hopelessly trying to change this dynamic.

Don’t neglect this conversation. The biggest step is to communicate clearly and honestly about the fact that you are there for her. “My one goal is to support you. It is important for me that you know I struggle when it feels like your difficult emotions are being directed at me. I cannot support you well if we do not have mutual respect and understanding.” From there, you can continue to work together to build up this new dynamic of mutual respect during cancer. This also just feels like a good moment to say fuck cancer.

  1. Sex!“I want you to know that my love and support for you does not diminish just because of cancer. I know that it can affect the intimacy and sex that we share. Can we have an open conversation about how we can continue to explore intimacy with each other?”

Surprise! It’s time for sex talk. It’s no secret that cancer can, might, and probably will have effects on the patient’s body and sexual drive. Our experience was from the perspective of breast cancer, so yeah…some bodily changes. On the bright side when it comes to body image and sex, it is at least one of the least complex things to address. There’s generally no defense mechanisms involved, so it is easier for both parties to approach this with a mutual understanding. Still, it is a very real challenge to tackle together. Your partner can have issues with body image. The sex drive may be affected. And things just might…be different.

Something that I read when Sarah and I were really close to getting married was this: Sex and intimacy in a relationship is not just the actual sex. It involves all the other lovey stuff like cuddling and kissing and what not. There are so many other ways to explore intimacy. Discuss with your partner about what you guys think will work. Trial and error. Truly the most important part here is to understand and empathize with your partner regarding the changes that might take place. Reassure them that even with the changes, you will love them and work with them to make the sex stuff work.

cancer eggplants

Navigating the tough conversations with your partner is crucial. There’s a million more that you can have and that I want to talk about. The main thing to keep in mind is that these conversations require empathy, understanding, and patience. Cancer sucks, but you might as well use it to build the trust and love that is already part of the relationship.

Cancer is not a solo endeavor. It is a team sport. You certainly aren’t alone. If anyone is reading this, at least know that there is one person (me) that gets it. In reality there are hundreds of thousands of us. Take care of yourself and thanks for reading!

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